Effect of population trends in body mass index on prostate cancer incidence and mortality in the United States.
Effect of population trends in body mass index on prostate cancer incidence and mortality in the United States.
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DOI：
10.1158/1055-9965.epi-08-0784
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Etzioni R
中科院分区：
文献类型：
--
作者：
Fesinmeyer MD;Gulati R;Zeliadt S;Weiss N;Kristal AR;Etzioni R
在美国，随着前列腺癌发病率的增加和前列腺癌死亡率的下降，肥胖的患病率一直在稳步增加。一些研究报告称，肥胖与高级别前列腺癌和前列腺癌死亡率的风险增加有关，因此肥胖的增加可能增加了前列腺癌的负担。在这项研究中，我们评估了肥胖增加对前列腺癌发病率和死亡率的潜在影响。我们首先使用前列腺癌预防试验的数据估计与肥胖相关的低度和高度前列腺癌的相对风险。然后，使用来自全国健康和营养检查调查的肥胖患病率数据和来自监测、流行病学和最终结果计划的前列腺癌发病率数据，我们将年度特定年级的前列腺癌发病率转换为以体重类别为条件的发病率。接下来，我们结合联合收割机的条件发病率与1980年的患病率为每一个体重类别的项目下，1980年的肥胖水平的年度特定年级的发病率。我们使用基于观察到的生存率和死亡率数据的模拟模型，将肥胖趋势对前列腺癌发病率的影响转化为对疾病特异性死亡率的影响。自1980年以来，肥胖患病率的预测增加使高级别前列腺癌发病率增加了15.5%，2002年前列腺癌死亡率增加了7.0%（在肥胖和非肥胖病例相同的生存率下）和23.0%（在肥胖和非肥胖病例不同的生存率下）。我们的结论是，自1980年以来肥胖患病率的增加部分掩盖了前列腺癌死亡率的下降。
Concurrent with increasing prostate cancer incidence and declining prostate cancer mortality in the United States, the prevalence of obesity has been increasing steadily. Several studies have reported that obesity is associated with increased risk of high-grade prostate cancer and prostate cancer mortality, and it is thus likely that the increase in obesity has increased the burden of prostate cancer. In this study, we assess the potential effect of increasing obesity on prostate cancer incidence and mortality. We first estimate obesity-associated relative risks of low- and high-grade prostate cancer using data from the Prostate Cancer Prevention Trial. Then, using obesity prevalence data from the National Health and Nutrition Examination Survey and prostate cancer incidence data from the Surveillance, Epidemiology, and End Results program, we convert annual grade-specific prostate cancer incidence rates into incidence rates conditional on weight category. Next, we combine the conditional incidence rates with the 1980 prevalence rates for each weight category to project annual grade-specific incidence under 1980 obesity levels. We use a simulation model based on observed survival and mortality data to translate the effects of obesity trends on prostate cancer incidence into effects on disease-specific mortality. The predicted increase in obesity prevalence since 1980 increased high-grade prostate cancer incidence by 15.5% and prostate cancer mortality by between 7.0% (under identical survival for obese and nonobese cases) and 23.0% (under different survival for obese and nonobese cases) in 2002. We conclude that increasing obesity prevalence since 1980 has partially obscured declines in prostate cancer mortality.